Videothoracoscopic approach to recurrence primary spontaneous pneumothorax: using of electrocoagulation in small bulla/blebs

Abstract

Objective To evaluate the effectiveness of electrocoagulation of bullae/blebs and apical pleurectomy via videothoracoscopic approach.Methods We reviewed 42 patients who underwent Videoassisted thoracoscopy (VATS) procedure for recurrence primary spontaneous pneumothorax (PSP) from 2000-2006. There were 30 male and 12 female patients with a median age of 30 years. The percentage of pneumothorax was calculated median of 60% (British Thoracic Society Guideline -2003). Thirty-two (76.2%) bullae/blebs were observed with the median diameter of 15 mm (5-30).Results Bulla ablation via cauterisation and apical pleurectomy was performed in 32 patients. Ten patients underwent only apical pleurectomy/abrasion because in this group there was not any either bulla or bleb could be found. The median duration of drainage time was 3 days. There was no mortality and complications occurred in fi ve (11.9%) patients. Only two (4.76%) recurrence occurred during the 52 months (5 to 76) median follow-up period.Conclusion Videothoracoscopic bulla ablation with apical pleurectomy is a safe method for recurrence PSP. Especially, if the bulla or bleb is smaller than 20 mm the ablation via cauterisation reduces the expenses of VATS procedure by avoiding the use of stapler devices.

Mechanical Pleurodesis Does Not Reduce Recurrence of Spontaneous Pneumothorax: A Randomized Trial

“…Seventeen patients had postoperative PSP recurrence (8 PA and 9 WR; 5.5% vs. 6.3%); the overall recurrence rate was 5.9%, consistent with previously reported rates of up to 12% prior reports [8,11,12]. Recurrence was not significantly different between groups (log-rank test p ¼ 0.791; Breslow test p ¼ 0.722, Fig 1).…”

Video Assisted Thoracic Surgery (VATS) Experience in Management of Primary Spontaneous Pneumothorax: Early Results

“…Our results revealed that Hospital stay ranged from 2-7 days with a mean (±SD) value of 27.05±6.75 years and no patient needed to ICU stay This was consistent with the findings of Merino et al [19] who conducted a retrospective review of 787 patients with PSP treated with abrasion and bullectomy and revealed a reduced surgical time, hospital stay, and complication rate with VATS. The frequency of recurrence following VATS pleurectomy or mechanical abrasion appears to be significantly higher than that described in previous research, based on available data [20] .…”

Safety and complications of medical thoracoscopy in the management of pleural diseases

“…When MT was used for pleurodesis, 3–5 g of talc was insufflated into the pleural cavity with a catheter and bulb syringe. Bulla electrocoagulation was commonly implemented in patients with recurrent pneumothorax [17]. When extensive adhesions were found under thoracoscopy and precluded lung re-expansion, adhesiolysis with biopsy forceps or electrothermal forceps was performed.…”